Graduated: 2018
NPI: 1821559873
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
201 N WASHINGTON ST
FALLS CHURCH, VA 220464518
7032374000
Source: CMS National Downloadable File, September 2026.